Overview
The National Action Plan for HIV/AIDS Control among Prisoners, Children, Inmates, and Clients (Rencana Aksi Nasional Pengendalian HIV/AIDS) is Indonesias comprehensive framework to reduce new infections, provide timely treatment, and improve the quality of life for vulnerable populations. Launched in 2023, the plan aligns with the global 959595 targets (95% diagnosed, 95% on antiretroviral therapy, 95% virally suppressed) while addressing the unique barriers faced by people who are incarcerated, children of affected families, former detainees, and community clients of health services.
Why It Matters
Several interrelated factors make these groups highrisk:
- Overcrowded facilities create environments where bloodborne infections spread quickly.
- Limited access to preventive tools such as condoms, clean needles, and PrEP (preexposure prophylaxis).
- Stigma and discrimination deter people from seeking testing or treatment.
- Legal and policy gaps that do not mandate routine HIV screening or continuity of care after release.
Children, particularly those born to HIVpositive mothers or living with affected relatives, face heightened risk of vertical transmission and psychosocial challenges. Addressing these issues early prevents longterm health repercussions and helps break the cycle of transmission.
Key Strategies
1. Strengthened Screening and Diagnosis
Mandatory rapid HIV testing on intake for all inmates and detainees.
Voluntary optout testing for children in health centers and schools.
Mobile testing units that visit remote prisons and rehabilitation centers.
2. Comprehensive Prevention Programs
Distribution of condoms and lubricants in prisons where legally permitted.
Needleandsyringe exchange programs (NSEPs) for inmates with a history of drug use.
Education campaigns using peer educators trained from within the prison population.
3. Integrated Treatment and Care
Immediate initiation of antiretroviral therapy (ART) for diagnosed individuals, following the same regimen used in the general population.
Continuity of care pathways that link prison health services with community clinics upon release.
Pediatric ART formulations and counseling for mothers and caregivers.
4. Capacity Building for Health Workers
Specialized training on HIV management in correctional settings.
Sensitization workshops to reduce stigma among prison staff and social workers.
Ongoing mentorship through regional health networks.
5. Legal and Policy Reform
Enact legislation that guarantees the right to HIV testing, treatment, and confidentiality for all incarcerated persons.
Align prison health standards with national health policies and WHO guidelines.
Provide legal assistance for inmates to navigate healthrelated rights.
6. Community Reintegration Support
Postrelease case management that includes housing, employment assistance, and psychosocial support.
Partnerships with NGOs to deliver counseling and peersupport groups.
Monitoring of ART adherence through community health workers.
Implementation Framework
The plan is structured around three pillars: Governance, Service Delivery, and Monitoring.
| Pillar | Key Actions | Responsible Entities |
|---|---|---|
| Governance | Form a National Coordination Committee; develop SOPs for prison health; allocate budget. | Ministry of Health, Ministry of Law & Human Rights, National AIDS Commission |
| Service Delivery | Equip prisons with testing kits; train staff; launch peereducation programs. | Regional Health Offices, Prison Administration, NGOs |
| Monitoring | Set up a digital reporting system; conduct quarterly audits; publish progress reports. | National AIDS Commission, Independent Auditors, Academic Partners |
Timeline (20232028)
- 20232024: Baseline assessments, policy drafting, pilot projects in 5 highrisk prisons.
- 20252026: Scaleup to all correctional facilities; integrate child health services.
- 20272028: Full national coverage; evaluation and revision based on outcomes.
Monitoring & Evaluation
Robust M&E is essential to track impact and ensure accountability. Core indicators include:
- Percentage of inmates screened for HIV within 30 days of admission.
- Proportion of HIVpositive inmates who start ART within 7 days of diagnosis.
- Retention rate on ART at 12 months for released individuals.
- Incidence of new HIV infections among children under five years old.
- Number of peer educators trained and active in each facility.
Data will be collected through a unified electronic health record (EHR) system, linked to the national HIV database. Quarterly dashboards will be shared with policymakers, civil society, and international partners.
Resources & Further Reading
For more detailed guidelines, tools, and contact information, visit the following sites:
- Ministry of Health HIV/AIDS Section
- UNODC Prison Health Resources
- World Health Organization HIV in Prisons
- UNAIDS Global 959595 Targets
Stakeholders interested in collaboration or funding can contact the National AIDS Commission at info@pembinas.kemkes.go.id.
